“Privacy and Interoperability are among our most pressing concerns and they often conflict in the real world,” argued Thomas Sullivan, MD, the chief strategy officer at the e-prescribing company DrFirst, and a past president of the Massachusetts Medical Society. “There are far too many examples of unnecessary redundancy in IDP and identity management of both providers and patients,” leading to “higher costs, inefficiency, errors, fraud and frustration throughout the industry."

The problem can manifest in multiple ways for patients and providers. Sullivan offered two examples.

For patients who decide what providers to share their information with, there is great privacy, yes, but also a “risk of danger and harm” if the information is incomplete or not shared in the event of emergencies.

For providers controlling identity attributes of patients, there are administrative efficiencies and “a certain element of patient safety added since it is easier to discover aggregate data that may bear on treatment decisions.” At the same time, “the patient loses a certain element of control regarding data sharing and thus, perhaps [there will be] less privacy protection,” Sullivan said.

Now, some see the solution to those identity and security problems as one with few risks, albeit with lingering controversy: a national patient identifier system.

While “some members have proposed that as one of several solutions, I’m sure we’re not trying to provide a national ID for all patients,” Sullivan said, referring to the Identity Ecosystem Steering Group he is also a member of. “Back when the HIPAA debate took place, it was clear we would not have a national patient identifier until Congress acted. But we are looking at ways to identity-proof patients and providers and to make those attributes a lot more usable.”

Indeed, the Healthcare Information and Management Systems Society (the parent organization of HIMSS Media, publisher of Healthcare IT News), the American Health Information Management Association and others are pushing a new idea as an alternative to a national patient ID system — a national patient matching system, options for which HIMSS in collaboration with HHS innovation fellows are currently exploring.

Whatever the outcome of those or other standards efforts, practitioners like Sullivan are just glad to see the problem of identity management starting to be addressed.

“It’s pretty rare that a physician would agree with anyone on anything," he said, "but I completely agree that we need to collaborate more between commerce and HHS."